This thread is to offer my personal experience with my initial ablation, blanking period and follow up ablation, both done by Dr. Natale. I stress that my experiences are, of course, grounded in my individuality as a high-mileage glob of protoplasm and other assorted organic material, and the plural of anecdote is not science. I offer the words herein in the hope that someone may benefit from them.
Briefly, I was diagnosed with AF 17 years ago at age 59. Like most folks, I was initially scared witless about the malady but from the little I learned about it I decided I was not going to let it ruin my life. My paroxysmal condition was well controlled for years primarily with propafenone plus rat poison and eventually dabigatran until it went persistent in late spring 2016. Thanks to another member of this forum I met Shannon and, in a little more than three weeks after our introduction, I was flat on my back in Dr. Natale's EP lab. About four+ total hours including 91 minutes of RF ablating later, I was staring at the ceiling in my room at St. David's Medical Center. Those of you who've been there know the drill, six hours of counting the holes in those fiberboard panels before you can sit up, squirm or act like a normal human. Reading the lab report several weeks later I was struck by two things: first, how badly the many years of AF had scarred my left atrium and second, why Dr. N's nickname is "The Maestro." It's absolutely amazing what that man can do with all those catheters. I'd really like to focus though on what goes on during the blanking period, that three month post procedure recovery time when it's just you and your ticker surviving on your own with maybe a couple of month's worth of anti-arrhythmia medication. The initial feeling of euphoria at being back in NSR may give way to some speed bumps on the road to total normalcy. The discharge instructions tell you that things can happen, including bouts of arrhythmia but they are not to be judged as a failure of the procedure, and this in my case was where things in my head were worse than the condition of my main drive pump. I had read of folks having PACs, but if I've ever had them I sure don't know it. On the other hand, I also knew that with my age and length of time with the malady the chance of being a "one and done" patient were slim. What I wasn't prepared for was a relapse into my original persistent state of cardioversions followed by a month to six weeks of NSR followed by another bout of arrhythmia, either AF or AFL. I had the procedure August 19th, was cardioverted the first time on September 20th, went out of rhythm again in late October after bouncing in and out of NSR and was cardioverted a second time on November 8th. One week after the 30 day cardioversion follow up with my local cardiologist I went into a flutter state and remained out of NSR until the morning of my second procedure on February 13th. Other than being quite short of breath when out of rhythm I felt pretty good physically and got regular cardio exercise at the gym. Mentally though life was one big "Aw s**t, not again!" My disposition ranged from that of a cornered cobra to a hermit that didn't want to be bothered by anyone or anything -- definitely a rotten way to live. I knew all along that there was a big chance things wouldn't go perfectly, but the slim possibility of being a single procedure patient was still a carrot out there on the horizon. Some things just aren't to be.
I am a participant in the Precept study being conducted by Dr. Natale to determine the efficacy of the ThermoCool® SMARTTOUCH™ SF catheter in treating symptomatic persistent AF. When Dr. Natale's staff learned I was again in persistent AFL they scheduled a second procedure for late March, but someone in the research department discovered that if I had to wait that long for the procedure I would wash out of the study so I was called on Friday afternoon, March10th, and asked if I could be in Austin within 48 hours. For me, when I was out of rhythm "the sooner the better" was always my desire to restore NSR so there was absolutely no question that I would drop everything and be at St. David's admitting office at 5:00 a.m. on March 13th. The lights went out about 7:20 or so and the next thing I knew I was again staring at those holes in the fiberboard ceiling. Unlike the first procedure this one was just light housekeeping as he called it and The Maestro was ablating for only 30 minutes with no cardioversions necessary during the procedure, much different from the first one when he had to jolt me twice and then isolate my left atrial appendage. He did not prescribe an anti-arrhythmia medication for the blanking period so I'm just cruising along with nothing but Xarelto and 5,000 IU of Vitamin D three times a week. I was quite surprised at how chipper I felt the day following the ablation, both body-wise and head-wise, and things have been consistently going up since. What will happen in the future? I absolutely don't know and am going to follow one of tenets of that famous Twelve Step program -- take it one day at a time. But that carrot is still out there and always will be.
Moral of the story -- don't let tales of blanking problems sway you one way or the other. Unlike other muscles, your heart is working 24/7 and may take longer to fully heal than others, particularly if you're in that portion of the population referred to as old fartdom. You are an individual and your body and mind will behave on their own. You can affect though what the little gray cells do, so don't let them prey on you. Remember, the worst day of a blanking period is far better than being on fire or getting shot at. Off the soap box!
